Table 1 Human GI toxicity rates from studies using hypofractionated radiotherapy for pancreatic cancer

Mahadevan et al. [7]

36

24

30 Gy 3 fx^a (median)

72

86.1 %

None

GI bleeding requiring transfusion, grade ≥ 3

2/36 (5.6 %)

5.6 %

Mahadevan et al. [8]

39

21

24 Gy 3 fx^a (median)

50

100 %

None

GI bleeding requiring transfusion, grade 3

2/39 (5.1 %)

7.7 %

Gastric outlet obstruction, grade 3

1/39 (2.6 %)

Lominska et al. [9]

28

5.9

21 Gy 3 fx^a + 50.4 Gy^c (median)

90

71 %

29 %

Bowel obstruction, grade 3

1/28 (3.6 %)

7.1 %

Gastric perforation, grade 3

1/28 (3.6 %)

Chang et al. [10]

77

6

25 Gy 1 fx^a (exact)

125

96 %

None

Biliary stricture, grade 3

2/77 (2.6 %)

9.1 %

Duodenal stricture, grade 3

1/77 (1.3 %)

Small bowel perforation, grade 4

1/77 (1.3 %)

Gastric ulcer, grade 3

3/77 (3.9 %)

Hoyer et al. [11]

22

3

45 Gy 3 fx^a (median)

147

None

13.6 %

Duodenum or stomach severe mucositis^d

2/22 (9.1 %)

22.7 %

Duodenum or stomach ulceration^d

2/22 (9.1 %)

Stomach perforation^d

1/22 (4.5 %)

Chuong et al. [12]

73

10.5

30 Gy 5 fx^a (median)

52

100 %

56 %

GI bleeding requiring embolization, grade 3

3/73 (4.1 %)

5.5 %

Anorexia resulting in feeding tube placement, grade 3

1/73 (1.4 %)

Schellenberg et al. [13]

20

11.8

25 Gy 1 fx^a (exact)

125

100 %

None

Duodenal perforation, grade ≥ 3

1/20 (5.0 %)

5.0 %

Didolkar et al. [14]

85

Unknown

25.5 Gy 3 fx^a (median)

55

100.0 %

16.5 %

Late duodenitis (upper GI hemorrhage or obstruction), grade ≥ 3

7/85 (8.2 %)

8.2 %

Polistina et al. [15]

23

9

30 Gy 3 fx^a (exact)

72

100 %

None

Late GI toxicity, grade ≥ 3

0/23 (0 %)

0.0 %

Rwigema et al. [16]

71

12.7

24 Gy 1 fx^a (median)

116

90 %

39 %

Late GI toxicity, grade ≥ 3

0/71 (0 %)

0.0 %

Ogawa et al. [17]

210

26.3

25 Gy 1 fx^b (median)

125

54.3 %

100 %

GI toxicity unspecified, grade 3

3/210 (1.4 %)

3.3 %

Colitis, grade 4

1/210 (0.5 %)

GI bleeding, grade 4

2/210 (1.0 %)

Ileus, grade 4

1/210 (0.5 %)

Willett et al. [18]

150

17

20 Gy 1 fx^b + 50.4 Gy^c (median)

133

100 %

82 %

Bleeding secondary to duodenal ulcer or erosion requiring medical intervention^d

16/150 (10.6 %)

15.0 %

Fatal duodenal bleeding, Grade 5

2/150 (1.3 %)

Duodenal obstruction^d

1/150 (0.6 %)

Abdominal wall dehiscence^d

1/150 (0.6 %)

Other^d

2/150 (1.3 %)

Mohiuddin et al. [19]

49

28

20 Gy 1 fx^b + 50 Gy^c (median)

133

100 %

None

Cholangitis, grade ≥ 3

2/49 (4.1 %)

16.3 %

GI bleeding, gastric antrum or transverse colon, grade ≥ 3

3/49 (6.1 %)

Bowel obstruction, grade ≥ 3

2/49 (4.1 %)

Enteritis, grade ≥ 3

1/49 (2 %)

Nishimura et al. [20]

55

Unknown

26 Gy 1 fx^b + 44 Gy^c (mean)

178

34.2 %

100 %

GI ulcer (non-perforating)^d

11/55 (20.0 %)

32.7 %

Intestinal perforation^d

2/55 (3.6 %)

Abdominal abscess^d

3/55 (5.5 %)

Ileus^d

2/55 (3.6 %)

71

29.3 Gy 1 fx^b + 41 Gy^c (mean)

209

27.4 %

None

GI ulcer (non-perforating)^d

7/71 (9.9 %)

19.7 %

Intestinal perforation^d

2/71 (2.8 %)

Abdominal abscess^d

1/71 (1.4 %)

Duodenal fibrosis^d

3/71 (4.2 %)

Ileus^d

1/71 (1.4 %)

Okamoto et al. [21]

68

Unknown

20 Gy 1 fx^b + 50 Gy^c (median)

135

8.8 %

94.1 %

Duodenal ulcer, bleeding^d

2/68 (2.9 %)

2.9 %

64

20 Gy 1 fx^b + 50 Gy^c (median)

135

None

100 %

Duodenal ulcer, fatal hemorrhagic shock, grade 5

1/64 (1.6 %)

1.6 %

Goldson et al. [22]

19

Unknown

22.5 Gy 1 fx^b (median)

102

None

None

GI ulcers, bile duct obstruction^d

2/19 (10.5 %)

10.5 %